Intestinal ultrasound in Crohn’s disease: A systematic review of its role in diagnosis, monitoring, and treatment response

Table 6 Summary of studies evaluating role of contrast enhanced ultrasound in characterizing strictures in Crohn’s disease

Ref.	Study type	Number of patients	IUS parameter	Follow-up	Results
Białecki et al[34], 2014	Prospective	42 (Adult CD)	CEUS	Cross-Sectional	CEUS correlated with endoscopic activity and fecal calprotectin; higher vascularity and peak enhancement indicated active CD
Ding et al[149], 2022	Prospective	76 (Adult CD)	CEUS vs CTE	Cross-Sectional	CEUS showed similar diagnostic accuracy to CTE for active inflammation; CEUS was better at detecting mural vascularization
Guidi et al[113], 2006	Prospective	25 (Adult CD)	CEUS	Cross-Sectional	CEUS predicted response to infliximab in active CD by assessing vascularization and bowel wall enhancement
Malagò et al[47], 2012	Prospective	30 (Adult CD)	CEUS vs MRI	Cross-Sectional	CEUS findings correlated well with MRI in lesion length, wall thickness, and inflammatory activity assessment
Nylund et al[44], 2013	Retrospective	37 (Adult CD)	Quantitative CEUS	Cross-Sectional	Quantitative CEUS differentiated inflammatory from fibrotic strictures based on blood flow and volume
Paredes et al[45], 2013	Prospective	60 (Adult CD Post-Surgery)	CEUS Parameters	Cross-Sectional	Sonographic score using CEUS achieved 98% sensitivity and 100% specificity for detecting postoperative recurrence; kappa = 0.946
Pauls et al[46], 2006	Prospective	21 (Adult CD)	CEUS vs Dynamic MRI	Cross-Sectional	High correlation between CEUS and MRI in assessing bowel wall vascularity; CEUS showed 217.5% enhancement compared to MRI's 262%, r = 0.623
Ponorac et al[48], 2023	Prospective	36 (Pediatric CD)	Quantitative CEUS, PCDAI, and fecal calprotectin	Cross-Sectional	Quantitative CEUS demonstrated 78.57% sensitivity and 100% specificity compared to endoscopy; substantial agreement with PCDAI (kappa = 0.62)
Wang et al[36], 2024	Retrospective	52	Dynamic CEUS parameters	12 months	CEUS showed high sensitivity (97.4%) and specificity (100%) for active CD
Ripollés et al[93], 2013	Retrospective	50 (Adult CD)	CEUS (Phlegmon vs Abscess)	Cross-Sectional	CEUS showed 100% specificity for distinguishing abscess from phlegmon, with excellent interobserver agreement (kappa = 0.953)
Ripollés et al[31], 2013	Prospective	25 (Adult CD undergoing surgery)	CEUS vs histopathology	Cross-Sectional	CEUS correctly classified 23/28 segments based on histopathological inflammation or fibrostenosis with substantial agreement (kappa = 0.632)

CD: Crohn’s disease; CEUS: Contrast-enhanced ultrasound; IUS: Intestinal ultrasound; CTE: Computed tomography enterography; MRI: Magnetic resonance imaging; PCDAI: Pediatric Crohn’s Disease Activity Index.